Tramazac is tramadol, a Schedule 5 prescription painkiller for moderate to severe pain that ordinary analgesics have not controlled. It comes as 50 mg capsules, slow-release tablets, an injection, and a combination tablet with paracetamol. It is habit-forming and is meant for short, defined courses.
What is Tramazac?
Tramazac contains tramadol hydrochloride. The South African Medicine Price Registry lists it in several forms, all Schedule 5:
| Product | Form | Strength |
|---|---|---|
| Tramazac | Capsule | Tramadol 50 mg |
| Tramazac | Injection | Tramadol 100 mg / 2 ml |
| Tramazac SR | Slow-release tablet | Tramadol 100 mg, 150 mg, 200 mg |
| Tramazac Co | Tablet | Tramadol with paracetamol 325 mg |
Tramadol is an opioid, though a weaker one than morphine, and it works in two ways at once. It acts on opioid receptors to dampen pain signals, and it also increases serotonin and noradrenaline in the spinal cord — the same neurotransmitters some antidepressants act on. That dual action makes it useful in nerve-related pain, and it also explains several of its interactions and side effects.
The SR tablets release tramadol slowly over about twelve hours for steady background pain control. They must be swallowed whole — crushing, splitting or chewing one releases the whole dose at once, which is dangerous.
Tramazac Co combines a smaller amount of tramadol with paracetamol. If you take it, do not take separate paracetamol on top.
What is Tramazac commonly used for?
Tramadol is prescribed for moderate to severe pain, usually where paracetamol or an anti-inflammatory has not been enough:
- Pain after surgery or a significant injury — the injection is used in hospital settings.
- Severe musculoskeletal and back pain, for short periods.
- Osteoarthritis pain, where anti-inflammatories are unsuitable or insufficient.
- Nerve pain — its serotonin and noradrenaline effect makes it somewhat more useful here than a pure opioid.
- Pain associated with cancer, as part of a wider plan.
- Renal colic and acute severe pain, in emergency settings.
It sits deliberately in the middle of the pain ladder: stronger than paracetamol or ibuprofen, weaker than morphine.
What it is not is a long-term answer to chronic pain. Evidence for lasting benefit in ongoing non-cancer pain is weak, while the risks of dependence, tolerance and side effects accumulate steadily with time.
How Tramazac fits into this medicine category
| Step | Examples | Where it fits |
|---|---|---|
| Simple analgesics | Paracetamol (Prolief, Donapan) | Mild pain and fever |
| Anti-inflammatories | Ibuprofen, diclofenac | Pain with inflammation |
| Weak opioids | Codeine, tramadol (Tramazac) | Moderate pain not controlled by the above |
| Strong opioids | Morphine, oxycodone | Severe pain, specialist supervision |
| Corticosteroids | Prednisone | Inflammatory conditions, as courses |
| Nerve-pain agents | Amitriptyline, pregabalin | Neuropathic pain specifically |
Tramadol is often combined with paracetamol, since the two work by different mechanisms and give better relief together than either alone. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Tramazac
Do not combine it with alcohol. Both suppress breathing and consciousness, and together the risk is substantially greater than either alone.
Tell your doctor or pharmacist if you:
- Take an antidepressant — SSRIs, SNRIs, tricyclics — or triptans for migraine, or the herbal remedy St John’s wort. Combining these with tramadol can cause serotonin syndrome. This is one of the most important interactions in everyday prescribing.
- Take benzodiazepines such as diazepam, or sleeping tablets. The combination with an opioid significantly raises the risk of dangerously slowed breathing.
- Have epilepsy or a history of seizures. Tramadol lowers the seizure threshold.
- Have kidney or liver disease — doses often need adjusting.
- Have breathing problems, particularly sleep apnoea or severe COPD.
- Have a history of dependence on opioids, alcohol or other substances.
- Are pregnant or breastfeeding.
- Are elderly — dose reductions and a higher risk of falls and confusion apply.
Check other painkillers for paracetamol if you are taking Tramazac Co, and for codeine or tramadol if you are taking anything else — doubling up on opioids is a common and serious error.
Do not drive until you know how it affects you. Drowsiness and slowed reactions are expected.
Swallow SR tablets whole. Follow the prescribed dose exactly; this page does not set doses.
Possible cautions and when to ask a pharmacist or doctor
Common effects include nausea, vomiting, dizziness, drowsiness, dry mouth, constipation and sweating. Nausea is frequent early on and often settles; constipation tends not to, and is worth managing from the start with fluid, fibre and, if needed, a laxative.
Seek emergency help for:
- Very slow, shallow or difficult breathing, extreme drowsiness or unresponsiveness — signs of opioid overdose.
- Seizures.
- Serotonin syndrome — agitation, confusion, fever, sweating, shivering, muscle twitching or a racing heart, especially after starting another serotonergic medicine.
- Swelling of the face or throat, or difficulty breathing from an allergic reaction.
Dependence and withdrawal are real. Taken regularly for more than a short period, the body adapts. Stopping abruptly can cause anxiety, sweating, insomnia, tremor, nausea and flu-like symptoms. If you have been taking it regularly, ask your doctor to plan a gradual reduction rather than stopping on your own.
Contact your doctor if pain is not controlled, if you find yourself needing more than prescribed, if drowsiness is interfering with daily life, or if the course is ending without a plan for what follows.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What is Tramazac used for? Moderate to severe pain that paracetamol or an anti-inflammatory has not controlled — after surgery or injury, in severe musculoskeletal pain, and in some nerve pain. It contains tramadol.
What is Tramazac injection used for? The same indication, given where an injection is needed — typically severe acute pain in a hospital or clinic setting.
Is Tramazac a strong painkiller? It is a weak opioid: stronger than paracetamol or ibuprofen, weaker than morphine.
Is it addictive? It can cause dependence, which is why it is Schedule 5 and prescribed for short courses. Do not stop abruptly after regular use — ask for a gradual reduction.
Can I take paracetamol with it? With plain Tramazac, often yes. With Tramazac Co, no — it already contains paracetamol. Check with a pharmacist.
Can I drink alcohol on it? No. The combination dangerously suppresses breathing.
Can I break an SR tablet in half? No. Swallow slow-release tablets whole; breaking one releases the entire dose at once.